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甲状腺疾病中的维生素 B12 水平:系统评价和荟萃分析。

Vitamin B12 levels in thyroid disorders: A systematic review and meta-analysis.

机构信息

Doctorado en Nutrición y Alimentos, Universidad San Ignacio de Loyola, Lima, Peru.

Unidad de Investigación para la Generacióny Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru.

出版信息

Front Endocrinol (Lausanne). 2023 Feb 22;14:1070592. doi: 10.3389/fendo.2023.1070592. eCollection 2023.

Abstract

BACKGROUND AND AIMS

Numerous studies have found an association between vitamin deficiency and thyroid disorders (TD). The presence of anti-parietal cell antibodies is indicative of reduced ability to absorb vitamin B12. Thus, this study reviewed the existing studies with the objective of assessing differences in the serum levels of vitamin B12 among patients with and without TD, the frequency of vitamin B12 deficiency in patients with TD, and the presence of anti-parietal cell antibodies in patients with TD.

METHODS

A meta-analysis of random-effects model was conducted to calculate pooled frequencies, mean differences (MD), and their respective 95% confidence intervals (CI). We identified 64 studies that met our inclusion criteria (n = 28597).

RESULTS

We found that patients with hypothyroidism had lower vitamin B12 levels than healthy participants (MD: -60.67 pg/mL; 95% CI: -107.31 to -14.03 pg/mL; p = 0.01). No significant differences in vitamin B12 levels were observed between healthy participants and patients with hyperthyroidism (p = 0.78), autoimmune thyroid disease (AITD) (p = 0.22), or subclinical hypothyroidism (SH) (p = 0.79). The frequencies of vitamin B12 deficiency among patients with hypothyroidism, hyperthyroidism, SH, and AITD were 27%, 6%, 27%, and 18%, respectively.

CONCLUSIONS

Patients with hypothyroidism had lower levels of vitamin B12 than healthy participants. No significant differences were observed between vitamin B12 levels and hyperthyroidism, AITD, or SH.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=324422, identifier (CRD42022324422).

摘要

背景与目的

许多研究发现维生素缺乏与甲状腺疾病(TD)之间存在关联。壁细胞抗体的存在表明维生素 B12 的吸收能力下降。因此,本研究回顾了现有的研究,旨在评估甲状腺功能减退症患者与无甲状腺功能减退症患者的血清维生素 B12 水平、甲状腺功能减退症患者维生素 B12 缺乏的频率以及甲状腺功能减退症患者壁细胞抗体的存在情况。

方法

采用随机效应模型的荟萃分析来计算汇总频率、平均差异(MD)及其各自的 95%置信区间(CI)。我们确定了符合纳入标准的 64 项研究(n=28597)。

结果

我们发现,甲状腺功能减退症患者的维生素 B12 水平低于健康参与者(MD:-60.67pg/ml;95%CI:-107.31 至-14.03pg/ml;p=0.01)。健康参与者与甲状腺功能亢进症(p=0.78)、自身免疫性甲状腺疾病(AITD)(p=0.22)或亚临床甲状腺功能减退症(SH)(p=0.79)患者的维生素 B12 水平无显著差异。甲状腺功能减退症、甲状腺功能亢进症、SH 和 AITD 患者的维生素 B12 缺乏频率分别为 27%、6%、27%和 18%。

结论

甲状腺功能减退症患者的维生素 B12 水平低于健康参与者。维生素 B12 水平与甲状腺功能亢进症、AITD 或 SH 之间无显著差异。

系统评价注册

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=324422,标识符(CRD42022324422)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5126/9994182/ecaa6c689a46/fendo-14-1070592-g001.jpg

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